Abstract 9809: Does Blood Transfusion Deteriorate the Prognosis in Targeted Temperature Management After Cardiac Arrest?
Introduction: It is well known that blood transfusion can worsen outcomes in patients with acute coronary syndrome without cardiac arrest. However, little is known regarding patients receiving blood transfusion after cardiac arrest in the current era of targeted temperature management (TTM) and coronary reperfusion.
Hypothesis: We assessed the hypothesis that blood transfusion worsen the prognosis of patients after cardiac arrest.
Methods: Adult comatose survivors of cardiac arrest treated with TTM were enrolled in this study. We assessed the association between blood transfusion and 90-day survival. We constructed 90-day survival curves using the Kaplan-Meier method to assess the impact of blood transfusion after cardiac arrest. Cox proportional hazards regression was utilized to adjust for the association of blood transfusion and 90-day survival. A P < 0.05 was defined as statistically significant.
Results: Among all study patients (N = 253), the median age was 62 years (interquartile range, 52 - 72 years), 75% were men, 51% had shockable initial rhythms, and the time interval from collapse to return of spontaneous circulation was 37 min (21 - 57 min). After hospital arrival, 60% of the study patients underwent immediate coronary angiography, 31% underwent subsequent coronary revascularization, and 99 patients (39%) received blood transfusions. The prevalence of blood transfusion were significantly higher in the patients underwent coronary revascularization (57% vs. 31%, P < 0.001). The 90-day survival curves are shown in the figure. Blood transfusion was independently associated with reduced 90-day survival (hazard ratio 0.68 [95% confidence interval, 0.47 - 0.98], P = 0.04).
Conclusions: Blood transfusion may worsen survival in patients not treated with coronary revascularization, but not in patients treated with coronary revascularization after cardiac arrest in the current TTM era.
Author Disclosures: E. Kagawa: None. K. Dote: None. M. Kato: None. S. Sasaki: None. Y. Kihara: None.
- © 2015 by American Heart Association, Inc.